Journal of Aging and Health最新文献

ObjectiveLimited research has explored how the attributions of discrimination in later life are related to cognitive functioning.MethodsWe analyzed responses from 12,279 adults ages 65+ in the 2008 to 2018 waves of the Health and Retirement Study. Multilevel mixed models assessed whether cognitive functioning was associated with (1) everyday discrimination (without reference to attribution) and (2) frequency of 11 attributions of discrimination.ResultsDescriptive analyses highlighted variability in the characteristics associated with specific attributions of discrimination. We found that age was the most reported attribution of discrimination, followed by gender. Discrimination was associated with worse cognitive functioning, and frequent reports of certain attributions of discrimination (e.g., disability, sexual orientation) were associated with cognitive functioning.DiscussionThese results suggested that discrimination was harmful for cognitive health and that the perceived reasons for discrimination may have unique and negative implications for cognitive functioning among older adults.

ObjectivesThe NIA health disparities research framework details a life course approach that considers multilevel environmental, sociocultural, behavioral, and biological factors. Mixed methods are well-suited to study complex problems like structural racism, combining the benefits of generalizability with contextualization.MethodsWe draw on experience as faculty in the Mixed Methods Research Training Program for the Health Sciences to introduce mixed methods research on health equity and disparities in dementia and cognitive impairment.ResultsWe describe common reasons why health science investigators may use mixed methods, provide examples of mixed methods designs, and discuss challenges and practicalities of mixed methods research.DiscussionMany risk factors for dementia are modifiable, so the emphasis of research turns from description to intervention studies that enhance health equity. The information and insights acquired from the use of mixed methods are central in tailoring interventions to populations most affected by Alzheimer's disease and related dementias.

ObjectiveThe objective of this study was to examine the interrelationships between cognitive performance, race/ethnicity, discrimination, health behaviors, and physiological dysregulation.MethodsWe used data from the Multi-Ethnic Study of Atherosclerosis (MESA) (N = 1667). We used path analyses to examine the association between discrimination, physiological dysregulation, health behaviors, and cognitive performance using the Cognitive Ability Screening Instrument (CASI) at Exam 5 (2010-12) and Exam 6 (2016-18). We examined the relationship between discrimination at Exam 1 (2000-02) and physiological dysregulation at Exam 5. We used overall and ethnoracial-stratified path analysis. All models were adjusted for age, sex, site, depression, stress, socioeconomic status, and APOE-e4.ResultsPhysiological dysregulation was associated with worse cognitive performance in the full sample and among the White ethnoracial subgroup. Everyday discrimination was associated with better cognitive performance among Black participants.DiscussionAssociations between discrimination, physiological dysregulation, and cognitive performance vary and should be examined longitudinally.

Objectives: This study examines the associations of ethnicity, caregiver burden, familism, and physical and mental health among Mexican Americans (MAs) and non-Hispanic Whites (NHWs).

Methods: We recruited adults 65+ years with possible cognitive impairment (using the Montreal Cognitive Assessment score<26), and their caregivers living in Nueces County, Texas. We used weighted path analysis to test effects of ethnicity, familism, and caregiver burden on caregiver's mental and physical health.

Results: 516 caregivers and care-receivers participated. MA caregivers were younger, more likely female, and less educated compared to NHWs. Increased caregiver burden was associated with worse mental (B = -0.53; p < .001) and physical health (B = -0.15; p = .002). Familism was associated with lower burden (B = -0.14; p = .001). MA caregivers had stronger familism scores (B = 0.49; p < .001).

Discussion: Increased burden is associated with worse caregiver mental and physical health. MA caregivers had stronger familism resulting in better health. Findings can contribute to early identification, intervention, and coordination of services to help reduce caregiver burden.

Objectives: Changes in socioeconomic status (SES) during life may impact health in old age. We investigated whether social mobility and childhood and adulthood SES are associated with trajectories of health-related quality of life (HrQoL) over a 17-year period.

Methods: We used data from the Helsinki Birth Cohort Study (n = 2003, 46% men, mean age 61.5 years). Social mobility was derived from childhood SES, obtained from healthcare records, and register-based adulthood SES.

Results: Logistic regression models showed that lower adulthood SES was associated with lower physical HrQoL trajectories. Among men low (OR 3.95, p < .001), middle (OR 2.20, p = .006), and declining lifetime SES (OR 2.41, p = .001) were associated with lower physical HrQoL trajectories compared to men with high SES. Socioeconomic status was not associated with mental HrQoL trajectories.

Discussion: Declining SES during life course may have negative health consequences, while improving SES is potentially as beneficial as high SES to later-life health among men.

Objective: To characterize aging-related health in women with past CLSI and compare with women with no-CLSI.

Method: Health and Retirement Study Wave 11 and 12 data from women age >50 with CLSI were compared with data from women age >50 with no-CLSI. Generalized linear models were estimated for aging-related health outcomes.

Results: The group with CLSI (n = 230) was significantly younger than the no-CLSI group (n = 8035) yet had more physical, functional, and mental health challenges and fewer resources. Incarceration significantly predicted aging-related outcomes of multimorbidity, polypharmacy, mortality, frailty, and depression.

Discussion: Earlier onset of physical and functional health conditions in women with past CLSI has implications for health education and promotion, clinical practice, and intervention design.

ObjectivesEngagement in learning new skills can potentially foster cognitive and functional growth among low-income Latinos, a population at high risk for developing Alzheimer's disease and related dementias. However, they may face unique barriers to learning. The present qualitative study identified learning barriers, learning engagement, and learning interests among low-income Latino older adults.MethodsTwenty Spanish-speaking participants were interviewed utilizing a semi-structured interview protocol. The data were analyzed using a thematic analysis approach.ResultsSome of the identified barriers include lacking good health, finances, learning opportunities, technology, proficiency in English, transportation, and motivation. Participants were most interested in learning technology, English, sewing skills, and culinary arts to primarily improve their financial situation.DiscussionThese findings highlight the privilege of prioritizing leisure activities for novel skill learning in old age for those with more financial resources. Our findings promote the need to provide tailored novel skill learning opportunities for underserved populations.

ObjectiveThis article introduces a special issue on advancing Alzheimer's disease (AD) and AD-related dementias (ADRD) research drawing from research conducted by the Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research (JHAD-RCMAR).MethodWe describe the JHAD-RCMAR, highlighting work of early career investigators in the JHAD-RCMAR, summarize key accomplishments, and propose recommendations for next steps in ameliorating disparities in cognitive decline and AD/ADRD risk.ResultsArticles in this special issue report on innovative research focused on basic, clinical, psychosocial, or health services aspects of minority aging, AD/ADRD, and health disparities. In addition, we include a paper on how mixed methods can be used to enhance health equity in research on AD/ADRD and cognitive impairment.DiscussionThe Supplement helps fill a critical knowledge gap regarding drivers of disparities in cognitive decline or risk in AD/ADRD, thereby informing future work as it relates to AD/ADRD and health equity.

Objectives: This study aims to establish the effects of ACEs on multimorbidity through sleep quality and investigate whether lifestyle factors (e.g., eating habits and exercise) may influence this relationship among middle-aged and older adults.

Methods: Participants were drawn from a cross-sectional sample of community dwelling older adults (N = 276, 55+) and three waves of data from the Midlife in the United States study (MIDUS, N = 843). We examined the direct and indirect effects of ACEs, sleep quality, and health conditions, as well as the conditional effects of physical activity and eating habits.

Results: Across both samples, sleep quality mediated the relationship between ACEs and chronic health conditions. Moderating effects of unhealthy eating and physical activity differed between samples.

Discussion: Sleep quality is an important pathway connecting ACEs and adult multimorbidity, and health behaviors may provide targets for intervention particularly in older adults.

Objectives: We examine whether early-life enrichment, involving varied and stimulating activities to enhance cognitive function during childhood and adolescence, is associated with cognitive function in later life and whether the benefits persist over time. Methods: Growth curve models were used to examine up to five waves of data from the Health and Retirement Study-a nationally representative survey of adults 50 years and older (N = 10,070). We constructed separate measures of early-life enrichment to distinguish sources of influence (i.e., enriched home environment and enriched school environment). Global cognitive function was assessed with a modified version of the Telephone Interview for Cognitive Status. Results: Greater enrichment in each environment was incrementally associated with better cognitive function at baseline, but enrichment was not associated with change in cognitive function over time. Discussion: Receiving enrichment from multiple environments during sensitive periods of cognitive development may be advantageous for cognitive functioning in later life.